Evaluation of Respiratory Distress

 in Mechanically Ventilated Patients




































If cause of respiratory distress still cannot be determined


  1. Measure Auto-PEEP, if > 5 cm H20, adjust vent settings and consider bronchodilators
  2. Check ventilator triggering “Sensitivity” and for circuit leaks
  3. Discontinue any in-line nebulization
  4. Adjust inspiratory flow rate to match patient’s demand; consider use of decelerating inspiratory flow “ramp” pattern with an adjusted peak flow rate
  5. Increase ventilator support:  increase IMV rate, Pressure support level, or place in assist-controlled mode
  6. Review possible causes of increased respiratory drive
    1. Increased minute ventilation requirement from

                                                    i.     Decompensation of underlying disease process

                                                  ii.     Pain

                                                iii.     Agitation